장간막의 염증성 근섬유모세포종 - 1예 보고 -

임성직,김교영,박재훈,김윤화,박용구,이주희,양문호 대한병리학회 1999 Journal of Pathology and Translational Medicine Vol.33 No.9

시상하부 과오종의 치료

김동석,박용구,최중언,정상섭 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

This study presents seven patients with hypothalamic hamartomas diagnosed on the basis of MRI. Histological confirmation was performed in one patient who underwent surgery. Four patients presented with epilepsy, including gelastic seizures. Other symptoms were behavior abnormalities in 3 patients and precocious puberty in 4 patients. We classify hypothalamic hamartomas into four subgroups according to MRI finding : Types Ⅰa lesions were less than 10㎜ in diameter and pedunculaedly attached to tuber cinereum of hypothalamus without hypothalamic displacement. Type Ⅰb lesions less than 10㎜ and mamillary body. Type Ⅱa lesions were more than 10㎜ in diameter and sessilely attached to hypothalamus with slight hypothalmic displacement and Type Ⅱb lesions more than 10㎜ and with marked displacement of hypothalamus. We could achieve good result with surgical resection in one patient with Type Ⅱb hamartoma associated with gelastic seizure that was unresponsive to medical treatment. We performed gamma knife ragiosurgery in three patients with gelastic seizure(2 patients with Type Ⅱa and 1 patient with Type Ⅱb) and three patients with precocious puberty(2 patients with Type Ⅰa and 1 patient with Type Ⅰb). The authors propose direct surgery as a treatment for this progressive syndrome and gamma knife radiosurgery as alternative treatment for high risk patients.

정신분열병 환자에서의 뇌위축

전진숙,박용구 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.4

Cerebral and cerebellar atrophic changes on computerized tomography (CT) scans of 18 schizophrenics and 25 age-matched controls were reviewed. Sizes of variable portions of ventricles and several cisterns was measured and presence of abnormal widenings of several subarachnoid cisterns was investigated on CT scans. The prevalences of both cerebral and cerebellar atrophy were significantly higher(p=0.001, p=0.001) in the schizophrenics than the controls. However, all of the atrophic changes were questionable or mild except two cases in each supratentorial and infratentorial structures. The cerebral and cerebellar atrophic changes had statistically significant positive linear correlation. The mean symptom duration was significantly longer in the undifferentiated type than the paranoid type (p=0.007), in the cases with negative symptom than with positive symptom(p=0.03). Negative symptoms were more in the undifferentiated type. These findings were consistent with previous reports that correlate the cerebral and cerebellar atrophies with schizophrenia and these results suggest that the brain atrophy in schizophrenics is not an isolated event but a feature of diffuse brain atrophy.

甚한 惡液質을 同伴한 若年性 進行痲痺 (晩發性 先天梅毒) 1例

田珍淑,朴容九 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.4

A 15 year-old boy, who had been ill in bed with pervasive cognitive impairment, poor intelligence, global aphasia, disuse muscular atropy, etc since the age of 11 years is reported under the impression of juvenile general paresis. His mother and an elder brother also had positive responses to serologic tests for syphilis. Brain computed tomography showed marked dilatation of ventricles without sulcal enlargement, which was interpreted as communicating hydrocephalus rather than cerebral atropy. He showed some improvements of intelligence and cognitive functions after intramuscular penicillin administration and ventriculoperitoneal shunt. However, it was not good enough to say that his daily living activities in general had improved.

癎疾患者의 局所的 腦血流

田珍淑,朴容九,廉夏勇 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.2

Although nuclear tomography had begun in 1959 by Kuhl, investigators has been interested in the SPECT since 1970s. Among various radionuclide tracers, technetium(Tc99m) has been known to be more available because it can be easily permeable through the blood-brain barrier, adequately retentive, and widely usable in the clinical field because of it's lower costs than the positron emission tomography(PET). So, 99m Tc-HMPAO SPECT has been used in the studies on cerebrovascular diseaese, dementias, epilepsy, tumor, migraine, schizophrenia, alcoholism and affective disorders, etc. In the epilepsy, it was reported that the cerebral blood flow was increased during ictal phase, but decreased during interictal period, while others insisted of interictal hyperperfusion due to subictal neuronal hyperactivity. We compared the cerebral blood flow of 17 epileptics with that of 12 neurotic controls measured by 99m Tc-HMPAO SPECT to observe the perfusion change in the interictal phase. The results were as follows : 1) Compared to the controls whose activity counts per frame were decreased to 5.5 ±3.3%(mean ±S.D.), 29.4% of epileptics showed hyperperfusion to 10.9±7.2%(p<0.05), and 70.6% showed hypoperfusion to 10.8±3.3%(p<0.001). 2) Most of foci of maximal blood flow change were located at the right hemisphere and posterior part. The foci in the anterior part could be found more in controls(33.3%), while posterior foci in epileptics(88.2% ;hyperperfusion group 80.8%, hyoperfusion group 91.6%) without statistical significance. 3) The degree of EEG abnormality was not correlated whit the activity counts per frame. Abnormal findings were more frequently seen in the hyperperfusion gruop(80.8%) than in the hypoperfusion group(41.7%) without statistical significance. The abnormal findings are mostly composed of high voltage(88.9%), and spike with or without wave(50.0%) or slow wave only(50.0%) without correlation with the activity counts per frame.

양성 뇌종양 : 뇌 수막종 Meningioma

정상섭,박용구,조용은 한국의학사 1987 診斷과治療 Vol.7 No.4

두부외상 환자의 치료 : 입원 결정의 · 지침 Criterion of Hospitalization

정상섭,박용구,조용은 한국의학사 1987 診斷과治療 Vol.7 No.5

Effects of Hydroxychloroquine Co-administered with Chemotherapeutic Agents on Malignant Glioma Cell Lines : in vitro Study

Park, Yong-Sook,Choi, Jae-Young,Chang, Jong-Hee,Park, Yong-Gou,Chang, Jin-Woo The Korean Neurosurgical Society 2005 Journal of Korean neurosurgical society Vol.38 No.1

Objective : Anti-malaria drugs may modulate tumor resistance to chemotherapeutic agents, but it has not been proven effective in the treatment of malignant gliomas. The aim of this study was to determine whether adequate pre-clinical data on co-administration of chemotherapeutic agents with anti-malaria drugs on malignant cell lines could be obtained that would warrant its further potential consideration for use in a clinical trial for malignant gliomas. Methods : Two malignant glioma cell lines [U87MG, T98G] were treated with chemotherapeutic agents alone or with anti-malaria drugs. Cells were incubated with drugs for 4 days. Following the 4-day incubation, drug sensitivity assays were performed using 3-[4,5-dimethyl-2-thiazol-2-yl] 2,5-diphenyltetrazolium bromide [MTT] assay following optimization of experimental conditions for each cell lines and cell viability was calculated. Results : In all of four chemotherapeutic agents[doxorubicin. vincrisitne, nimustine, and cisplatin], the cell viability was found to be markedly decreased when hydroxychloroquine was co-administered on both U87MG and T98G cell lines. The two way analysis of variance[ANOVA] yielded a statistically significant two-sided p-value of 0.0033[doxorubicin], 0.0005[vincrisitne], 0.0007[nimustine], and 0.0003[cisplatin] on U87MG cell lines and 0.0006[doxorubicin], 0.0421[vincrisitne], 0.0317[nimustine], and 0.0001[cisplatin] on T98G cell lines, respectively. However, treatment with chloroquine and primaquine did not induce a decrease in cell viability on both U87MG and T98G cell lines. Conclusion : Our data support further consideration of the use of hydroxychloroquine prior to systemic chemotherapy to maximize its tumoricidal effect for patients with malignant gliomas.

Treatment Options of Metastatic Brain Tumors from Hepatocellular Carcinoma: Surgical Resection vs. Gamma Knife Radiosurgery vs. Whole Brain Radiation Therapy

Tae Yong Park,Young Chul Na,Won Hee Lee,Ji Hee Kim,장원석,Hyun Ho Jung,Jong Hee Chang,Jin Woo Chang,Young Gou Park 대한뇌종양학회 2013 Brain Tumor Research and Treatment Vol.1 No.2

Objective Although metastasis of hepatocellular carcinoma to the brain is uncommon, it is associated with a very high mortality rate and most patients usually expire within 1 year after brain metastasis. The aim of this study is to identify the effectiveness of the active interventions such as gamma knife radiosurgery or surgical intervention for these patients. Methods We retrospectively reviewed the medical records and imaging data of 59 patients with metastatic brain tumors from hepatocellular carcinoma from May 2004 to September 2012. The study included patients with available clinical and radiological data who had been diagnosed with metastatic hepatocellular carcinoma of the brain, confirmed by magnetic resonance imaging. The overall survival time was analyzed and compared according to each risk factor. Results The mean age at diagnosis of metastatic brain tumor was 52.2 years (14-77). The mean follow-up duration was 13.3 weeks (0.1-117.6). Overall median survival was 4.3 weeks (95% confidence interval, 2.2-6.4). The results from an analysis of clinical factors related to survival revealed that treatment modalities were significantly related to the patient’s survival (log rank, p=0.006). Twenty patients (32.8%) experienced tumor bleeding, and the survival time of the patients with tumor bleeding tended to be shorter, although the result was not statistically significant (log rank, p=0.058). Hepatic reserve, by Child-Pugh classification, was grade A in 38 patients (64.4%), grade B in 16 patients (27.1%), and grade C in 5 patients (8.5%), and was significantly related to the patient’s survival (log rank, p=0.000). Conclusion Although patients with metastatic brain tumors from hepatocellular carcinoma showed poor survival, active intervention including surgical resection or gamma knife radiosurgery may result in better survival, especially if patients have preserved liver function.

Treatment Options of Metastatic Brain Tumors from Hepatocellular Carcinoma; Surgical Resection vs. Gamma Knife Radiosurgery vs. Whole Brain Radiation Therapy

( Tae Yong Park ),( Young Chul Na ),( Won Hee Lee ),( Ji Hee Kim ),( Won Seok Chang ),( Hyun Ho Jung ),( Jong Hee Chang ),( Jin Woo Chang ),( Young Gou Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2013 Brain Tumor Research and Treatment Vol.1 No.2

Objective: Although metastasis of hepatocellular carcinoma to the brain is uncommon, it is associated with a very high mortality rate and most patients usually expire within 1 year after brain metastasis. The aim of this study is to identify the effectiveness of the active interventions such as gamma knife radiosurgery or surgical intervention for these patients. Methods: We retrospectively reviewed the medical records and imaging data of 59 patients with metastatic brain tumors from hepatocellular carcinoma from May 2004 to September 2012. The study included patients with available clinical and radiological data who had been diagnosed with metastatic hepatocellular carcinoma of the brain, confirmed by magnetic resonance imaging. The overall survival time was analyzed and compared according to each risk factor. Results: The mean age at diagnosis of metastatic brain tumor was 52.2 years (14-77). The mean follow-up duration was 13.3 weeks (0.1-117.6). Overall median survival was 4.3 weeks (95% confidence interval, 2.2-6.4). The results from an analysis of clinical factors related to survival revealed that treatment modalities were significantly related to the patient`s survival (log rank, p=0.006). Twenty patients (32.8%) experienced tumor bleeding, and the survival time of the patients with tumor bleeding tended to be shorter, although the result was not statistically significant (log rank, p=0.058). Hepatic reserve, by Child-Pugh classification, was grade A in 38 patients (64.4%), grade B in 16 patients (27.1%), and grade C in 5 patients (8.5%), and was significantly related to the patient`s survival (log rank, p=0.000). Conclusion: Although patients with metastatic brain tumors from hepatocellular carcinoma showed poor survival, active intervention including surgical resection or gamma knife radiosurgery may result in better survival, especially if patients have preserved liver function.